Mary, Mary, Quite Contrary

Mary Mayhew, who dismantled social welfare programs in Maine, is now Trump's appointee to gut Medicaid.

(AP Photo/Robert F. Bukaty, File)

Mary Mayhew on May 5, 2018, in Augusta, Maine

There’s no better way to drive a stake through the heart of anti-poverty programs than to appoint a new administrator with documented success in heaving low-income adults and children off of social welfare systems.

America, meet Mary Mayhew, aka “Mary Mayhem,” as she is sometimes known in her home state of Maine. The former secretary of Maine’s Department of Health and Health Human Services (DHHS) is now the number two at the Centers for Medicare and Medicaid Services (CMS) and director of Medicaid and Children’s Health Insurance Program.

Could Mayhew be any worse than any other official appointed by President Trump to strangle an agency from within?

Yes, she could. The announcement of her appointment prompted a collective gasp from the Pine Tree State.

Like the many of the rapacious industry insiders whom Trump has unleashed on regulatory bodies like the Environmental Protection Agency, Mayhew was also a lobbyist—in her case, working for the Maine Hospital Association. But she also brings a special talent that not every denizen-of-corporate-America-turned-Trumpista can claim.

As Maine’s top health administrator, Mayhew became one of the country’s most effective state practitioners of the Republican dark arts of regulatory retreat. Moreover, her move to Washington to work with CMS Administrator Seema Verma is a reunion for this dynamic duo. In 2012, Mayhew recruited Verma, then a health policy consultant immersed in reconfiguring Indiana’s Medicaid program, to assist Maine officials with their Medicaid overhaul.

Appointed to her post by Maine Governor Paul “Trump before Trump” LePage seven years ago, Mayhew led the assault on Maine’s welfare supports. If a program could be sliced or diced, Mayhew did it.

Even before LePage came on the scene, Maine was the poorest state in the Northeast, and his administration did nothing to help its poorer residents. After the passage of the Affordable Care Act, it was the only state in the Northeast that failed to expand Medicaid.

Maine quickly became a laboratory for the best methods to gut Medicaid, and Mainers its lab rats. About 25,000 Mainers were tossed off Medicaid in 2013 alone after the state implemented stricter eligibility rules overseen by Mayhew. Mayhew’s DHHS also applied for a federal waiver that would allow the state to implement not just work requirements for Medicaid, but force people to pay monthly premiums, and a $20 co-pay for “inappropriate emergency room use” and other indignities. (She has since recused herself from any decisions involving Maine’s pending waiver.)

Mayhew didn’t restrict her mayhem to Medicaid, of course. She dragged her feet on dealing with the opioid epidemic and presided over a paring back of Supplemental Nutrition Assistance Program (SNAP) benefits and implementing work requirements for SNAP recipients.

The result? Hunger shot up. Maine now ranks third in the nation in the rate of its residents who experience hunger, behind Alabama and Louisiana. There are now 80 food pantries serving state residents and one-quarter of those opened in the past five years, according to Preble Street, a Portland anti-poverty organization.

Appalled by the state’s refusal to expand Medicaid eligibility, Mainers placed an initiative on the ballot that put Medicaid expansion to a vote, with the prospect of health care for an additional 80,000 people hanging in the balance. The measure passed easily last year, but LePage did not budge, vetoed legislation to get expansion moving, and has kept stalling even after even after the Maine Supreme Court directed him to create an implementation plan. Not surprisingly, LePage is spending the waning days of his tenure going mano-a-mano with the state courts.

Mayhew got to watch these more recent developments from afar having departed state government in the middle of 2017 to seek the Republican gubernatorial nomination. She did not deviate from her hardline on social services during her unsuccessful 2018 GOP primary campaign, voicing, for instance, strong opposition to a November ballot initiative that would guarantee home health care for seniors and people with disabilities through a tax on wealthier Mainers.

With more than 50 percent of Mainers disapproving of her ex-boss, she continued to trumpet saving taxpayer dollars by getting a handle on the supposed waste, fraud, and abuse that accompanies all government programs.

But Maine Republicans were done with such far right-wing drivel. Mayhew came in third in a four-way race for GOP nomination for governor, with just 15 percent of the vote, failing even to carry even her hometown.

The headline for a Portland Press Herald editorial marking her departure from Augusta nicely summed up her career: “Mary Mayhew has a history of misplaced priorities.” With Mayhew and Verma now reunited in Washington, however, expect more battles of the sort that led to mayhem in Maine. The poorest Americans will get poorer, victims of the smug ideologues who seek cuts to social welfare services to pay for their tax cuts, and of Republicans’ drive to rally their base.